To observe and explore the effects of different fluid management strategies on the left ventricular diastolic function in patients with sepsis.

As a prospective cohort study, 96 patients with sepsis admitted to the hospital during October 2015 to June 2018.The patients were randomly divided into two groups after early fluid resuscitation.Each group was of 48 cases.Treatment group was received restrictive fluid management strategies and the control group was continued to carry out open liquid management.Then liquid cumulative balance was observed with different periods, and the duration of mechanical ventilation, ICU duration and multiple organ dysfunction syndrome in two groups were observed and compared in 28 days after in ICU.The left ventricular diastolic function was measured by ultrasound, and the ratio of early diastolic velocity of mitral valvular and early diastolic velocity of mitral annulus (E/E′) was observed.Meanwhile, the myocardial injury markers like troponin-I(cTnI)and N-proBNP were observed at 1st day, 2 nd day 3 rd day and 4 th day in ICU.

After the early target treatment, the two groups of patients were positively balanced in fluid within 1 day of transfering to the ICU.The net balance of the patients in the fluid-restricted group was significantly lower than that in the non-restricted group during the ICU treatment (P<0.05). From the third day of ICU treatment, the E/E′ and cTnI of the fluid-restricted group began to decrease significantly compared with the liquid non-restricted group.On the third day of treatment, the NT-proBNP of the fluid-restricted group was significantly lower than that of the non-restricted group (P<0.05). E/E′, cTnI and NT-proBNP values in patients in the fluid-restricted group decreased significantly on the third day compared with the second day in the ICU (P<0.05); E/E′ and cTnI in patients in the non-restricted group the decrease was not obvious, and NT-proBNP was increased (P>0.05).

There is still a wide range of left ventricular diastolic dysfunction in patients with sepsis after the early volume of capacity.The restrictive liquid management strategy can significantly shorten the patient′s ICU time, improve the left ventricular diastolic function, reduce the myocardial injury and improve the prognosis of the patients.

Sepsis; Restrictive fluid management strategies; Open liquid management strategies; Left ventricular diastolic dysfunction